Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $83.18 / $107.15 / $269.15	Facility	26	$83.18	$107.15	$269.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $426.58 / $870.96	Professional		$234.42	$426.58	$870.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $107.15 / $218.78	Professional	26	$56.23	$107.15	$218.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $177.83 / $323.59 / $549.54	Professional	TC	$177.83	$323.59	$549.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $141.25 / $190.55	Professional		$141.25	$141.25	$190.55
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $53.70 / $97.72	Professional	26	$39.81	$53.70	$97.72
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $144.54 / $144.54	Professional	TC	$144.54	$144.54	$144.54
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $501.19 / $812.83	Professional		$257.04	$501.19	$812.83
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $77.62 / $128.82	Professional	26	$50.12	$77.62	$128.82
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $199.53 / $416.87 / $724.44	Professional	TC	$199.53	$416.87	$724.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $537.03 / $1,000.00	Professional		$275.42	$537.03	$1,000.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $87.10 / $165.96	Professional	26	$52.48	$87.10	$165.96
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $218.78 / $436.52 / $891.25	Professional	TC	$218.78	$436.52	$891.25
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $281.84 / $1,412.54	Professional		$218.78	$281.84	$1,412.54
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $75.86 / $199.53	Professional	26	$56.23	$75.86	$199.53
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $208.93 / $1,318.26	Professional	TC	$162.18	$208.93	$1,318.26
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $173.78 / $389.05	Professional		$57.54	$173.78	$389.05
United Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $446.68 / $776.25	Professional		$223.87	$446.68	$776.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $67.61 / $128.82	Professional	26	$52.48	$67.61	$128.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $354.81 / $676.08	Professional	TC	$169.82	$354.81	$676.08